Hypoglycemia occurred on hospitalized patients would result in severe complications.So we monitored the blood glucose of hospitalized patients with diabetes in 14 clinical departments from January to December 2013.Tot...Hypoglycemia occurred on hospitalized patients would result in severe complications.So we monitored the blood glucose of hospitalized patients with diabetes in 14 clinical departments from January to December 2013.Totally 105728 cases of blood glucose were monitored and 1374 cases of hypoglycemia were detected.The incidence of hypoglycemia was 1.29%.Among which,317 cases of severe hypoglycemia were detected and the incidence of severe hypoglycemia was 0.29%.The peak periods of hypoglycemia were 0:00~2:00,22:00~24:00,2:00~4:00,8:00~10:00 and 10:00~12:00.The symptomatic hypoglycemia accounted for 47.01%,The asymptomatic hypoglycemia accounted for 52.98%.The incidence of hypoglycemia was 1.49%in medical departments and 0.87%in surgical departments.It is suggested to be vigilant of high risk periods of hypoglycemia,detect and treat asymptomatic hypoglycemia timely and rationally administer antidiabetics to prevent hypoglycemia.展开更多
Diabetes mellitus (DM) is a chronic metabolic condition characterized predominantlyby hyperglycemia. The most common causes contributing to the pathophysiologyof diabetes are insufficient insulin secretion, resistance...Diabetes mellitus (DM) is a chronic metabolic condition characterized predominantlyby hyperglycemia. The most common causes contributing to the pathophysiologyof diabetes are insufficient insulin secretion, resistance to insulin’stissue-acting effects, or a combination of both. Over the last 30 years, the globalprevalence of diabetes increased from 4% to 6.4%. If no better treatment or cure isfound, this amount might climb to 430 million in the coming years. The major fact-ors of the disease’s deterioration include age, obesity, and a sedentary lifestyle.Finding new therapies to manage diabetes safely and effectively without jeopardizingpatient compliance has always been essential. Among the medicationsavailable to manage DM on this journey are glucagon-like peptide-1 agonists,thiazolidinediones, sulphonyl urease, glinides, biguanides, and insulin-targetingreceptors discovered more than 10 years ago. Despite the extensive preliminarystudies, a few clinical observations suggest this process is still in its early stages.The present review focuses on targets that contribute to insulin regulation andmay be employed as targets in treating diabetes since they may be more efficientand secure than current and traditional treatments.展开更多
BACKGROUND In recent years,studies have found that the occurrence and development of diabetic cardiomyopathy(DCM)is closely related to an increase in polyadenosine diphosphate-ribose polymerase-1(PARP-1)activity.PARP-...BACKGROUND In recent years,studies have found that the occurrence and development of diabetic cardiomyopathy(DCM)is closely related to an increase in polyadenosine diphosphate-ribose polymerase-1(PARP-1)activity.PARP-1 activation could be involved in the pathophysiological process of DCM by promoting oxidative stress,the inflammatory response,apoptosis and myocardial fibrosis.AIM To investigate the mechanism of liraglutide in improving myocardial injury in type 2 diabetic rats,further clarified the protective effect of liraglutide on the heart,and provided a new option for the treatment of DCM.METHODS Forty healthy male SD rats aged 6 wk were randomly divided into two groups,a normal control group(n=10)and a model group(n=30),which were fed an ordinary diet and a high-sugar and high-fat diet,respectively.After successful modeling,the rats in the model group were fed a high-glucose and high-fat diet for 4 wk and randomly divided into a model group and an intervention group(further divided into a high-dose group and a low-dose group).The rats were fed a high-glucose and high-fat diet for 8 wk and then started drug intervention.Blood samples were collected from the abdominal aorta to detect fasting blood glucose and lipid profiles.Intact heart tissue was dissected,and its weight was used to calculate the heart weight index.Haematoxylin and eosin staining was used to observe the pathological changes in the myocardium and the expression of PARP-1 in the heart by immunohistochemistry.RESULTS The body weight and heart weight index of rats in the model group were significantly increased compared with those in the normal control group,and those in the intervention group were decreased compared with those in the model group,with a more obvious decrease observed in the high-dose group(P<0.05).In the model group,myocardial fibers were disordered,and inflammatory cells and interstitial fibrosis were observed.The cardiomyopathy of rats in the intervention group was improved to different degrees,the myocardial fibers were arranged neatly,and the myocardial cells were clearly striated;the improvement was more obvious in the high-dose group.Compared with the normal control group,the expression of PARP-1 in myocardial tissue of the model group was increased,and the difference was statistically significant(P<0.05).After liraglutide intervention,compared with the model group,the expression of PARP-1 in myocardial tissue was decreased,and the reduction was more obvious in the high-dose group(P<0.05)but still higher than that in the normal control group.CONCLUSION Liraglutide may improve myocardial injury in type 2 diabetic rats by inhibiting the expression of myocardial PARP-1 in a dose-dependent manner.展开更多
BACKGROUND Somatostatin analogues are an established first-line therapy for well differentiated small bowel neuroendocrine tumours(Wd-SBNETs),while and peptide receptor radionuclide therapy(PRRT)is frequently used as ...BACKGROUND Somatostatin analogues are an established first-line therapy for well differentiated small bowel neuroendocrine tumours(Wd-SBNETs),while and peptide receptor radionuclide therapy(PRRT)is frequently used as a second-line therapy.Adequate treatment selection of third-line treatment remains challenging due to the limited prospective data currently available on the best therapeutic sequence.AIM To understand current practice and rationale for decision-making by physicians in the 3rd-line setting by building an online survey.METHODS Weighted average(WA)of likelihood of usage between responders(1 very unlikely;4 very likely)was used to reflect the relevance of factors explored.RESULTS Replies from representatives of 28 centers were received(5/8/2020-21/9/2020);medical oncologist(53.6%),gastroenterologist(17.9%);United Kingdom(21.4%),Spain(17.9%),Italy(14.3%).Majority from European Neuroendocrine Tumor Society(ENETS)Centres of Excellence(57.1%),who followed ENETS guidelines(82.1%).Generally speaking,3rd-line treatment for Wd-SBNETs was:everolimus(EVE)(66.7%),PRRT(18.5%),liver embolization(LE)(7.4%)and interferon-alpha(IFN)(3.7%);chemotherapy(0%);decision was based on clinical trial data(59.3%),or personal experience(22.2%).EVE was most likely used if Ki-67<10%(WA 3.27/4)or age<70 years(WA 3.23/4),in the 3rd-line setting(WA 3.23/4);regardless of presence/absence of carcinoid syndrome(CS),rate of progression or extent of disease.Chemotherapy was mainly utilised only if rapid progression(within 6 mo)(WA 3.35/4),Ki-6710%-20%(WA 2.77/4),negative somatostatin receptor imaging(WA 2.65/4)or high tumour burden(WA 2.77/4);temozolomide or streptozocin was used with capecitabine or 5-fluorouracil(5-FU)(57.7%),FOLFOX(5-FU combined with oxaliplatin)(23.1%).LE was selected if presence of CS(WA 3.24/4)or Ki-67<10%(WA 2.8/4),after progression to other treatments(WA 2.8/4).IFN was rarely used(WA 1.3/4).CONCLUSION Everolimus was the most frequently used therapeutic option in the third-line setting.The most important factors for decision-making included Ki-67,rate of progression,functionality and tumour burden;since this decision is based on multiple factors,it highlights the need for a multidisciplinary assessment.展开更多
The aim of this study was to explore the associations of moderate-to-vigorous-intensity physical activity(MVPA)time and sedentary(SED)time with a history of cardiovascular disease(CVD)and multifactorial(i.e.,blood pre...The aim of this study was to explore the associations of moderate-to-vigorous-intensity physical activity(MVPA)time and sedentary(SED)time with a history of cardiovascular disease(CVD)and multifactorial(i.e.,blood pressure(BP),body mass index(BMI),low-density lipoprotein cholesterol(LDL-C),and glycated hemoglobin A1c(HbA1c))control status among type 2 diabetes mellitus(T2DM)patients in China.A cross-sectional analysis of 9152 people with type 2 diabetes from the Multifactorial Intervention on Type 2 Diabetes(MIDiab)study was performed.Patients were grouped according to their self-reported MVPA time(low,<150 min·week−1;moderate,150 to<450 min·week−1;high,≥450 min·week−1)and SED time(low,<4 h·d–1;moderate,4 to<8 h·d–1;high,≥8 h·d–1).Participants who self-reported a history of CVD were identified as having a CVD risk.Odds ratios(ORs)and 95%confidence intervals(CIs)of CVD risk and multifactorial control status associated with MVPA time and SED time were estimated using mixed-effect logistic regression models,adjusting for China’s geographical region characteristics.The participants had a mean±standard deviation(SD)age of(60.87±8.44)years,44.5%were women,and 25.1%had CVD.After adjustment for potential confounding factors,an inverse association between high MVPA time and CVD risk that was independent of SED time was found,whereas this association was not observed in the moderate-MVPA group.A higher MVPA time was more likely to have a positive effect on the control of BMI.Compared with the reference group(i.e.,those with MVPA time≥450 min·week−1 and SED time<4 h·d–1),CVD risk was higher in the low-MVPA group:The OR associated with an SED time<4 h·d–1 was 1.270(95%CI,1.040–1.553)and that associated with an SED time≥8 h·d–1 was 1.499(95%CI,1.149–1.955).We found that a high MVPA time(i.e.,≥450 min·week−1)was associated with lower odds of CVD risk regardless of SED time among patients with T2DM.展开更多
BACKGROUND Hyperthyroidism often leads to tachycardia,but there are also sporadic reports of hyperthyroidism with severe bradycardia,such as sick sinus syndrome(SSS)and atrioventricular block.These disorders are a cha...BACKGROUND Hyperthyroidism often leads to tachycardia,but there are also sporadic reports of hyperthyroidism with severe bradycardia,such as sick sinus syndrome(SSS)and atrioventricular block.These disorders are a challenge for clinicians.CASE SUMMARY We describe three cases of hyperthyroidism with SSS and found 31 similar cases in a PubMed literature search.Through the analysis of these 34 cases,we found 21 cases of atrioventricular block and 13 cases of SSS,with 67.6%of the patients experiencing bradycardia symptoms.After drug treatment,temporary pacemaker implantation,or anti-hyperthyroidism treatment,the bradycardia of 27 patients(79.4%)was relieved,and the median recovery time was 5.5(2-8)d.Only 7 cases(20.6%)needed permanent pacemaker implantation.CONCLUSION Patients with hyperthyroidism should be aware of the risk of severe bradycardia.In most cases,drug treatment or temporary pacemaker placement is recommended for initial treatment.If the bradycardia does not improve after 1 wk,a permanent pacemaker should be implanted.展开更多
BACKGROUND Obesity is associated with an increased risk of multiple extradigestive complic-ations.Thus,understanding the global epidemiology of obesity and its relation-ship with extradigestive complications,such as c...BACKGROUND Obesity is associated with an increased risk of multiple extradigestive complic-ations.Thus,understanding the global epidemiology of obesity and its relation-ship with extradigestive complications,such as cardiovascular disease,type 2 diabetes mellitus,and non-alcoholic fatty liver disease is important.However,nutritional intervention can positively manage issues associated with obesity.Hence,the identification of the current high prevalence of extradigestive complica-tions among patients with obesity and the potential role of nutritional inter-ventions is also essential.AIM To determine the relationship between obesity and extradigestive complications and emphasize the importance of nutritional interventions in the management of patients with obesity.METHODS Overall,110 patients with obesity admitted to our hospital from February 2020 to November 2022 and 100 healthy individuals were included in the present study.Information of the study population,including demographic characteristics,such as age,sex,body mass index,indicators of extradigestive complications,dietary intake,and biomarkers was collected.The study design,participant selection,interventions,and development of the nutritional intervention program were described.The collected data were analyzed to assess the effect of nutritional inter-ventions on extradigestive complications.RESULTS As a part of nutritional intervention,the dietary structure was modified to decrease the saturated fatty acid and cholesterol intake and increase the dietary fiber and polyunsaturated fatty acid intake to improve the blood lipid levels and cardiovascular health.Mechanistic studies showed that these nutritional inter-ventions positively affected mechanisms that regulate lipid metabolism,improved inflammatory markers in the blood,and improved vascular functions.CONCLUSION The study discusses the consistency of the present results with previous findings to assess the clinical significance of the present findings.The study provides direction for future research on improving nutritional intervention strategies.展开更多
Objective:To investigate the variation,expression and clinical significance of E2F3 gene in melanoma.Methods:Firstly,cBioportal database,Oncomine database and GEO database were used to analyze the variation and expres...Objective:To investigate the variation,expression and clinical significance of E2F3 gene in melanoma.Methods:Firstly,cBioportal database,Oncomine database and GEO database were used to analyze the variation and expression level of E2F3 gene in melanoma.OSskcm database and TISIDB database were used to analyze the relationship between E2F3 and melanoma prognosis and tumor immune infiltrating cells.Then,the LinkedOmics database was used to identify the differential genes related to E2F3 expression in melanoma and analyze their biological functions.Finally,small molecule compounds for the treatment of melanoma were screened through the CMap database.Results:The mutation rate of E2F3 gene in melanoma is about 4%,and there are 21 mutation sites.Compared with normal skin tissues,the expression of E2F3 gene in melanoma was significantly increased(P<0.01).The mutation and increased expression of E2F3 gene were associated with the shortened overall survival(OS)of melanoma patients(P<0.05).The CNA level of E2F3 was negatively correlated with the expression levels of lymphocytes such as pDC,Neutrophil,Act DC and Th17,and negatively correlated with the expression levels of chemokines such as CXCL5,CCL13 and CCR1.The methylation level of E2F3 was positively correlated with the expression levels of Th1,Neutrophil,Act DC and other lymphocytes,and positively correlated with the expression levels of CXCL16,CXCL12,CCR1 and other chemokines.The expression level of E2F3 was negatively correlated with the expression levels of lymphocytes such as Th17,Tcm CD4 and Th1,and negatively correlated with the expression levels of chemokines such as CXCL 16,CCL 22 and CCL 2.The expression of 96 genes such as UHRF1BP1 in melanoma was significantly correlated with the expression of E2F3(|cor|0.5,P<0.05).The above genes were mainly related to RNA transport,eukaryotic ribosome biogenesis,cell cycle and other pathways.Among them,WDR12,WDR43,RBM28,UTP18,DKC1,PAK1IP1,DDX31,TEX10,TRUB1 and TRMT61B were the top 10 hub genes.YC-1,simvastatin,cytochalasin-d,Deforolimus and cytochalasin-b may be five small molecule compounds for the treatment of melanoma.Conclusion:The mutation and increased expression level of E2F3 gene are related to the poor prognosis of melanoma and participate in the occurrence and development of melanoma by affecting the expression of different tumor immune infiltrating cell subtypes,which may be a potential diagnostic marker and therapeutic target for melanoma.展开更多
In recent years, the incidence of neurodegenerative diseases, mainly Alzheimer’s disease, Parkinson’s disease, vascular dementia, and cerebral ischemia, has been rising gradually, which has a serious impact on the p...In recent years, the incidence of neurodegenerative diseases, mainly Alzheimer’s disease, Parkinson’s disease, vascular dementia, and cerebral ischemia, has been rising gradually, which has a serious impact on the physiological state and quality of life of human beings in old age, and the current clinical drugs are unsatisfactory in terms of therapeutic efficacy and healing, which has made this kind of diseases become a social medical problem. Tea polyphenols are the main functional components of tea and have great potential in neuroprotection. In this paper, we review the research on tea polyphenols in neurodegenerative diseases, with the aim of providing a new entry point for the treatment of neurodegenerative diseases.展开更多
BACKGROUND Gastrointestinal surgery is a complicated process used to treat many gastrointestinal diseases,and it is associated with a large trauma:Most patients often have different degrees of malnutrition and immune ...BACKGROUND Gastrointestinal surgery is a complicated process used to treat many gastrointestinal diseases,and it is associated with a large trauma:Most patients often have different degrees of malnutrition and immune dysfunction before surgery and are prone to various infectious complications during postoperative recovery,thus affecting the efficacy of surgical treatment.Therefore,early postoperative nutritional support can provide essential nutritional supply,restore the intestinal barrier and reduce complication occurrence.However,different studies have shown different conclusions.AIM To assess whether early postoperative nutritional support can improve the nutritional status of patients based on literature search and meta-analysis.METHODS Articles comparing the effect of early nutritional support and delayed nutritional support were retrieved from PubMed,EMBASE,Springer Link,Ovid,China National Knowledge Infrastructure,China Biology Medicine databases.Notably,only randomized controlled trial articles were retrieved from the databases(from establishment date to October 2022).The risk of bias of the included articles was determined using Cochrane Risk of Bias V2.0.The outcome indicators,such as albumin,prealbumin,and total protein,after statistical intervention were combined.RESULTS Fourteen literatures with 2145 adult patients undergoing gastrointestinal surgery(1138 patients(53.1%)receiving early postoperative nutritional support and 1007 patients(46.9%)receiving traditional nutritional support or delayed nutritional support)were included in this study.Seven of the 14 studies assessed early enteral nutrition while the other seven studies assessed early oral feeding.Furthermore,six literatures had"some risk of bias,"and eight literatures had"low risk".The overall quality of the included studies was good.Meta-analysis showed that patients receiving early nutritional support had slightly higher serum albumin levels,than patients receiving delayed nutritional support[MD(mean difference)=3.51,95%CI:-0.05 to 7.07,Z=1.93,P=0.05].Also,patients receiving early nutritional support had shorter hospital stay(MD=-2.29,95%CI:-2.89 to-1.69),Z=-7.46,P<0.0001)shorter first defecation time(MD=-1.00,95%CI:-1.37 to-0.64),Z=-5.42,P<0.0001),and fewer complications(Odd ratio=0.61,95%CI:0.50 to 0.76,Z=-4.52,P<0.0001)than patients receiving delayed nutritional support.CONCLUSION Early enteral nutritional support can slightly shorten the defecation time and overall hospital stay,reduce complication incidence,and accelerate the rehabilitation process of patients undergoing gastrointestinal surgery.展开更多
·AIM: To determine the effects of laser photocoagulation on serum levels of angiopoietin-1(Ang-1),angiopoietin-2(Ang-2), soluble angiopoietin receptor Tie-2(Tie-2), Ang-1/Ang-2 ratio and vascular endothelial grow...·AIM: To determine the effects of laser photocoagulation on serum levels of angiopoietin-1(Ang-1),angiopoietin-2(Ang-2), soluble angiopoietin receptor Tie-2(Tie-2), Ang-1/Ang-2 ratio and vascular endothelial growth factor(VEGF) in patients with type 2diabetes mellitus(T2DM) and proliferative diabetic retinopathy(PDR). We also explored the role of the Ang/Tie system in PDR.·METHODS:Totally 160patientswithT2 DM, including50 patients with non-diabetic retinopathy(NDR), 58 patients with non-proliferative diabetic retinopathy(NPDR), and52 patients with PDR were enrolled in this study. Serum Ang-1, Ang-2, Tie-2 receptor and VEGF levels were measured using enzyme-linked immunosorbent assays for all patients and were repeated in 26 patients who underwent laser photocoagulation two months after the procedure.·RESULTS:ThemedianlevelsofAng-2andVEGFinserum were significantly higher in the NPDR group(4.23 ng/mL and 303.2 pg/mL, respectively) compared to the NDR group(2.67 ng/mL and 159.8 pg/mL, respectively, P <0.01), with the highest level in the PDR group(6.26 ng/mL and531.2 pg/mL, respectively, P <0.01). The median level of Ang-1 was significantly higher in the NPDR group(10.77ng/mL) compared to the NDR group(9.31 ng/mL) and the PDR groups(9.54 ng/mL)(P <0.05), while no difference was observed between the PDR and NDR groups. Ang-1/Ang-2 ratio of PDR group was lowest in three groups(1.49 vs 2.69 and 2.90, both P <0.01). The median level of Tie-2was not significantly different among three groups(P >0.05).Ang-2 was positively correlated with VEGF and Tie-2 in the PDR and NPDR groups(both P <0.05). Among the 26 patients who underwent laser photocoagulation, serum Ang-2 and VEGF levels significantly decreased(both P <0.05), whereas serum Ang-1 level and Ang-1/Ang-2ratio were weakly increased(P >0.05). The median levels of Ang-2 and VEGF in serum were highest in PDR group,however, Ang-1/Ang-2 ratio of PDR group was lowest in three groups.·CONCLUSION: Laser photocoagulation can reduce serum Ang-2 and VEGF levels. The Ang/Tie system and VEGF play an important role in the development and progression of T2 DM patients with PDR.展开更多
The relationship of metabolic syndrome(MS)and its components with incident chronic kidney disease(CKD)and rapid decline of estimated glomerular filtration rate(eGFR)was investigated.A total of 10 140 patients particip...The relationship of metabolic syndrome(MS)and its components with incident chronic kidney disease(CKD)and rapid decline of estimated glomerular filtration rate(eGFR)was investigated.A total of 10 140 patients participating in the epidemiological study(Risk Evaluation of Cancers in Chinese Diabetic Individuals,REACTION)of risk factors of type 2 diabetes in China were followed up for 3 years,with MS being diagnosed by adult treatment panel IH(ATP IH)combined with waist circumference in Asian population and renal function being evaluated by eGFR<60 mL min^-1(1.73 m^2)^-1 and rapid decline of eGFR≤30%.The results showed that as compared with the non-MS group,the adjusted odds ratios(ORs)of CKD and rapid decline of eGFR were 1.64(OR:1.64;95%CI:1.20-2.25,P<0.05)and 1.23(OR:1.23;95%CI:1.05-1.43,P<0.05)respectively in MS group.With the increase in the number(0,1,2,3 and≥4)of MS components,the prevalence of CKD was 1.42%,1.44%,2.80%,3.42%,and 4.03%(P<0.001),respectively.The ORs of incident CKD were 1.67(OR:1.67;95%CI:1.22-2.27,P<0.05)for high TG,1.50(OR:1.50;95%CI:1.10-2.05,P<0.05)for low HDL-C,and 1.39(OR:1.39;95%CI:1.02-1.91,P<0.05)for hyperglycemia.The risk for developing incident CKD was higher in the group with the highest HOMA-IR than in the group with the lowest HOMA-IR(OR:1.83;95%CI:1.16-2.89,P<0.05).It is suggested that MS is an independent risk factor for incident CKD.The occurrence and development of CKD is closely related to insulin resistance.展开更多
Objective:To study the correlation of lipid ratios and individual lipid indexes of patients with type 2 diabetes with glycosylated hemoglobin(HbA<sub>1c</sub>).Methods:Samples were collected from 128 type ...Objective:To study the correlation of lipid ratios and individual lipid indexes of patients with type 2 diabetes with glycosylated hemoglobin(HbA<sub>1c</sub>).Methods:Samples were collected from 128 type 2 diabetic patients（aged 19-90 years;male 72,female 56）.The sera were analyzed for HbA<sub>1c</sub>,total cholesterol（TC）,triglycerides（TG）,high-density lipoprotein cholesterol（HDL-C） and low-density lipoprotein cholesterol（LDL-C）.According to the HbA<sub>1e</sub> level,the patients were divided into three groups,group A(HbA<sub>?</sub>【7%,n=31),group B(7%【HbA<sub>1c</sub>【10%,n=48),and group C(HbA<sub>1c</sub>】10%,n=49).The correlation of HbA<sub>1c</sub>with lipid ratios & individual lipid indexes were analyzed.Results:With the increased level of HbA（1c）,LDL-C had a significantly increasing trend（P【0.05）;whereas TC went up with the increased HbA（1c）,without any significant differences between three groups.There was no significant correlation between HbA<sub>1c</sub> and TG or HDL-C. With the increased level of HbA<sub>1c</sub>,TC/HDL-C,LDL-C/HDL-C ratios were gradually increased, with significant differences among groups（P【0.05）.The lipid ratios,especially LDL-C/HDL-C ratio was more susceptible to impaired lipid metabolism in T2DM patients than individual lipid. Conclusions:LDL-C/HDL-C ratio is helpful in assessing and reducing the risk of cardiovascular disease caused by impaired lipid metabolism in type 2 diabetic patients.展开更多
In the 1970s,with the advent of biochemical multichannel screening in the United States and other western countries,the clinical presentation of primary hyperparathyroidism(PHPT) changed from a symptomatic to an asymp...In the 1970s,with the advent of biochemical multichannel screening in the United States and other western countries,the clinical presentation of primary hyperparathyroidism(PHPT) changed from a symptomatic to an asymptomatic disorder.However,in Asian countries,like China,PHPT did not show this evolution,but rather continued to be a symptomatic disease with target organ involvement.In this paper,we revisit the clinical features of PHPT in New York and Shanghai,representative United States and Chinese cites,over the past decade.The questions we address are whether the disease evolved in China to a more asymptomatic one and,whether in the United States further changes are evident.The results indicate that while PHPT con-tinues to present primarily as an asymptomatic disease in the United States,a new phenotype characterized by normal serum calcium and high parathyroid hormone levels,normocalcemic PHPT,has emerged.Data from Shanghai demonstrates a trend for PHPT to present more commonly as an asymptomatic disorder in China.However,most patients with PHPT in China still manifest classical symptoms,i.e.nephrolithiasis and fractures.A comparison of the two cohorts shows that Chinese patients with PHPT are younger,with higher serum calcium and PTH levels,and lower 25-hydroxyvitamin D levels than patients in New York.Normocalcemic PHPT has not yet been recognized in Shanghai.In summary,although the phenotypes of PHPT in both cities are evolving towards less evident disease,sharp clinical and biochemical differences are still apparent in PHPT as expressed in China and the United States.展开更多
Background: Nonalcoholic fatty liver disease(NAFLD) was recently proposed to be renamed metabolic dysfunction-associated fatty liver disease(MAFLD) with the diagnostic criteria revised. We investigated the similaritie...Background: Nonalcoholic fatty liver disease(NAFLD) was recently proposed to be renamed metabolic dysfunction-associated fatty liver disease(MAFLD) with the diagnostic criteria revised. We investigated the similarities and differences in the prevalence and clinical characteristics of MAFLD and NAFLD in Chinese adults. Methods: A cross-sectional study of 9980 Chinese individuals aged 40 years or older was performed between 2011 and 2012 using randomized, stratifed cluster sampling in Shanghai, China. A detailed questionnaire and the results of abdominal ultrasonography, a standardized 2-h 75-g oral glucose tolerance test and blood biochemical examinations were collected. Results: A total of 9927 subjects were included in this study. The prevalence of MAFLD(40.3%) was significantly higher than that of NAFLD(36.9%)( P < 0.05). MAFLD was highly prevalent in type 2 diabetes mellitus(T2DM)(53.8%), impaired fasting glucose(35.7%) and impaired glucose tolerance(40.9%). High risk of advanced fbrosis based on fbrosis-4 was highly prevalent(14.7%) in lean MAFLD with T2DM. Among 9927 subjects, 3481(35.1%) fulflled the diagnostic criteria for MAFLD and NAFLD(MAFLD + NAFLD +), 521(5.2%) MAFLD + NAFLD-, and 181(1.8%) MAFLD-NAFLD +. The MAFLD + NAFLD-group had more signifcant metabolic disorders than those in the MAFLD + NAFLD + group(all P < 0.05). Among MAFLD-NAFLD + subjects, 82.9% had metabolic disorders. Conclusions: The new defnition of MAFLD may better reflect the pathogenesis related to metabolism. Future research should focus on studying the natural history, pathogenesis and treatment effectivity of the overlap and non-overlap of NAFLD and MAFLD subjects.展开更多
This study was designed to investigate the effect of neoadjuvant chemotherapy on the expression of hormone receptors and Ki67 in Chinese female breast cancer patients. The expression of estrogen receptor(ER), progeste...This study was designed to investigate the effect of neoadjuvant chemotherapy on the expression of hormone receptors and Ki67 in Chinese female breast cancer patients. The expression of estrogen receptor(ER), progesterone receptor(PR) and Ki67 among 525 neoadjuvant chemotherapy cases was studied by immunohistochemistry.Differences between specimens made through preoperative core needle biopsy and excised tissue biopsy were observed. The positive rates of ER, PR and Ki67 in core needle biopsy and excised tissue biopsy were 65.3% and 63.2%, 51.0% and 42.6%, 65.6% and 43.4%, respectively. The expression of ER, PR and Ki67 in core needle biopsy and excised tissue biopsy had no statistically significant difference. However, after neoadjuvant chemotherapy, the discordance rates of ER, PR and Ki67 were 15.2%(79/521), 26.9%(140/520) and 44.8%(225/502), respectively. The ER, PR and Ki67 status changed from positive to negative in 7.5%(39/521), 13.3%(69/520) and 21.1%(106/502) of the patients, whereas ER, PR and Ki67 status changed from negative to positive in 7.7%(40/521), 13.6%(71/520)and 23.7%(119/502) of the patients, respectively. These results showed that the status of some biomarkers changes after neoadjuvant chemotherapy and biomarker status needs to be reexamined to optimize adjuvant systemic therapy and better prognosis assessment.展开更多
Objective To study the optimal waist circumference(WC) cut-off values for identifying metabolic risk factors in middle-aged and elderly subjects in Shandong Province of China. Methods A total of 2 873 men and 5 559 wo...Objective To study the optimal waist circumference(WC) cut-off values for identifying metabolic risk factors in middle-aged and elderly subjects in Shandong Province of China. Methods A total of 2 873 men and 5 559 women were included in this cross-sectional study. Metabolic syndrome(MetS) was diagnosed according to the definition of Chinese Diabetes Society in 2004. The relation between WC and MetS was analyzed by multivariate logistic regression analysis. The optimal WC cut-off values were identified using the area under the ROC curve and the different diagnostic criteria for central obesity were compared. Results The WC was the risk factor for MetS independent of BMI, blood glucose, blood lipid, and blood pressure. The optimal WC cut-off value was 83.8 cm and 91.1 cm for identifying MetS in women and men, respectively. Compared with 80 cm and 85 cm for women and men, 85 cm and 90 cm had a higher Youden index for identifying all metabolic risk factors and MetS in women and men. Conclusion The appropriate WC cut-off value is 85 cm and 90 cm for identifying central obesity and MetS in women and men in Shandong Province of China.展开更多
Objective To compare the influence of different sulfonylureas on the myocardial protection effect of ischemic preconditioning (IPC) in isolated rat hearts, and ATP-sensitive potassium channel current (IKATP) of rat ve...Objective To compare the influence of different sulfonylureas on the myocardial protection effect of ischemic preconditioning (IPC) in isolated rat hearts, and ATP-sensitive potassium channel current (IKATP) of rat ventricular myocytes. Methods Isolated Langendorff perfused rat hearts were randomly assigned to five groups: (1) control group, (2) IPC group, (3) IPC+glibenclamide (GLB, 10 μmol/L) group, (4) IPC+glimepiride (GLM, 10 μmol/L) group, (5) IPC+gliclazide (GLC, 50 μmol/L) group. IPC was defined as 3 cycles of 5-minute zero-flow global ischemia followed by 5-minute reperfusion. The haemodynamic parameters and the infarct size of each isolated heart were recorded. And the sarcolemmal IKATP of dissociated ventricular myocytes reperfused with 10 μmol/L GLB, 1 μmol/L GLM, and 1 μmol/L GLC was recorded with single-pipette whole-cell voltage clamp under simulated ischemic condition. Results The infarct sizes of rat hearts in IPC (23.7%±1.3%), IPC+GLM (24.6%±1.0%), and IPC+GLC (33.1%±1.3%) groups were all significantly smaller than that in control group (43.3%±1.8%; P<0.01, n=6). The infarct size of rat hearts in IPC+GLB group (40.4%±1.4%) was significantly larger than that in IPC group (P<0.01, n=6). Under simulated ischemic condition, GLB (10 μmol/L) decreased IKATP from 20.65±7.80 to 9.09±0.10 pA/pF (P<0.01, n=6), GLM (1 μmol/L) did not significantly inhibit IKATP (n=6), and GLC (1 μmol/L) decreased IKATP from 16.73±0.97 to 11.18±3.56 pA/pF(P<0.05, n=6). Conclusions GLM has less effect on myocardial protection of IPC than GLB and GLC. Blockage of sarcolemmal ATP-sensitive potassium channels in myocardium might play an important role in diminishing IPC-induced protection of GLM, GLB, and GLC.展开更多
文摘Hypoglycemia occurred on hospitalized patients would result in severe complications.So we monitored the blood glucose of hospitalized patients with diabetes in 14 clinical departments from January to December 2013.Totally 105728 cases of blood glucose were monitored and 1374 cases of hypoglycemia were detected.The incidence of hypoglycemia was 1.29%.Among which,317 cases of severe hypoglycemia were detected and the incidence of severe hypoglycemia was 0.29%.The peak periods of hypoglycemia were 0:00~2:00,22:00~24:00,2:00~4:00,8:00~10:00 and 10:00~12:00.The symptomatic hypoglycemia accounted for 47.01%,The asymptomatic hypoglycemia accounted for 52.98%.The incidence of hypoglycemia was 1.49%in medical departments and 0.87%in surgical departments.It is suggested to be vigilant of high risk periods of hypoglycemia,detect and treat asymptomatic hypoglycemia timely and rationally administer antidiabetics to prevent hypoglycemia.
文摘Diabetes mellitus (DM) is a chronic metabolic condition characterized predominantlyby hyperglycemia. The most common causes contributing to the pathophysiologyof diabetes are insufficient insulin secretion, resistance to insulin’stissue-acting effects, or a combination of both. Over the last 30 years, the globalprevalence of diabetes increased from 4% to 6.4%. If no better treatment or cure isfound, this amount might climb to 430 million in the coming years. The major fact-ors of the disease’s deterioration include age, obesity, and a sedentary lifestyle.Finding new therapies to manage diabetes safely and effectively without jeopardizingpatient compliance has always been essential. Among the medicationsavailable to manage DM on this journey are glucagon-like peptide-1 agonists,thiazolidinediones, sulphonyl urease, glinides, biguanides, and insulin-targetingreceptors discovered more than 10 years ago. Despite the extensive preliminarystudies, a few clinical observations suggest this process is still in its early stages.The present review focuses on targets that contribute to insulin regulation andmay be employed as targets in treating diabetes since they may be more efficientand secure than current and traditional treatments.
基金Supported by Shanxi Provincial Natural Science Foundation,No.201701D121159Shanxi Provincial Health and Family Planning Commission,No.2014016Health Commission of Shanxi Province,No.2019020.
文摘BACKGROUND In recent years,studies have found that the occurrence and development of diabetic cardiomyopathy(DCM)is closely related to an increase in polyadenosine diphosphate-ribose polymerase-1(PARP-1)activity.PARP-1 activation could be involved in the pathophysiological process of DCM by promoting oxidative stress,the inflammatory response,apoptosis and myocardial fibrosis.AIM To investigate the mechanism of liraglutide in improving myocardial injury in type 2 diabetic rats,further clarified the protective effect of liraglutide on the heart,and provided a new option for the treatment of DCM.METHODS Forty healthy male SD rats aged 6 wk were randomly divided into two groups,a normal control group(n=10)and a model group(n=30),which were fed an ordinary diet and a high-sugar and high-fat diet,respectively.After successful modeling,the rats in the model group were fed a high-glucose and high-fat diet for 4 wk and randomly divided into a model group and an intervention group(further divided into a high-dose group and a low-dose group).The rats were fed a high-glucose and high-fat diet for 8 wk and then started drug intervention.Blood samples were collected from the abdominal aorta to detect fasting blood glucose and lipid profiles.Intact heart tissue was dissected,and its weight was used to calculate the heart weight index.Haematoxylin and eosin staining was used to observe the pathological changes in the myocardium and the expression of PARP-1 in the heart by immunohistochemistry.RESULTS The body weight and heart weight index of rats in the model group were significantly increased compared with those in the normal control group,and those in the intervention group were decreased compared with those in the model group,with a more obvious decrease observed in the high-dose group(P<0.05).In the model group,myocardial fibers were disordered,and inflammatory cells and interstitial fibrosis were observed.The cardiomyopathy of rats in the intervention group was improved to different degrees,the myocardial fibers were arranged neatly,and the myocardial cells were clearly striated;the improvement was more obvious in the high-dose group.Compared with the normal control group,the expression of PARP-1 in myocardial tissue of the model group was increased,and the difference was statistically significant(P<0.05).After liraglutide intervention,compared with the model group,the expression of PARP-1 in myocardial tissue was decreased,and the reduction was more obvious in the high-dose group(P<0.05)but still higher than that in the normal control group.CONCLUSION Liraglutide may improve myocardial injury in type 2 diabetic rats by inhibiting the expression of myocardial PARP-1 in a dose-dependent manner.
基金Dr Angela Lamarca received funding from The Christie CharityDr.Joakim Crona received funding from CancerfondenThe design of the survey and its distribution was supported by COR2ED and the NETConnect group(funded by Ipsen).
文摘BACKGROUND Somatostatin analogues are an established first-line therapy for well differentiated small bowel neuroendocrine tumours(Wd-SBNETs),while and peptide receptor radionuclide therapy(PRRT)is frequently used as a second-line therapy.Adequate treatment selection of third-line treatment remains challenging due to the limited prospective data currently available on the best therapeutic sequence.AIM To understand current practice and rationale for decision-making by physicians in the 3rd-line setting by building an online survey.METHODS Weighted average(WA)of likelihood of usage between responders(1 very unlikely;4 very likely)was used to reflect the relevance of factors explored.RESULTS Replies from representatives of 28 centers were received(5/8/2020-21/9/2020);medical oncologist(53.6%),gastroenterologist(17.9%);United Kingdom(21.4%),Spain(17.9%),Italy(14.3%).Majority from European Neuroendocrine Tumor Society(ENETS)Centres of Excellence(57.1%),who followed ENETS guidelines(82.1%).Generally speaking,3rd-line treatment for Wd-SBNETs was:everolimus(EVE)(66.7%),PRRT(18.5%),liver embolization(LE)(7.4%)and interferon-alpha(IFN)(3.7%);chemotherapy(0%);decision was based on clinical trial data(59.3%),or personal experience(22.2%).EVE was most likely used if Ki-67<10%(WA 3.27/4)or age<70 years(WA 3.23/4),in the 3rd-line setting(WA 3.23/4);regardless of presence/absence of carcinoid syndrome(CS),rate of progression or extent of disease.Chemotherapy was mainly utilised only if rapid progression(within 6 mo)(WA 3.35/4),Ki-6710%-20%(WA 2.77/4),negative somatostatin receptor imaging(WA 2.65/4)or high tumour burden(WA 2.77/4);temozolomide or streptozocin was used with capecitabine or 5-fluorouracil(5-FU)(57.7%),FOLFOX(5-FU combined with oxaliplatin)(23.1%).LE was selected if presence of CS(WA 3.24/4)or Ki-67<10%(WA 2.8/4),after progression to other treatments(WA 2.8/4).IFN was rarely used(WA 1.3/4).CONCLUSION Everolimus was the most frequently used therapeutic option in the third-line setting.The most important factors for decision-making included Ki-67,rate of progression,functionality and tumour burden;since this decision is based on multiple factors,it highlights the need for a multidisciplinary assessment.
基金supported by the National Key Research and Development Program of China(2017YFC1309800)the“Outstanding University Driven by Talents”Program and Academic Promotion Program of Shandong First Medical University(2019LJ007)the Key Research and Development Program of Shandong Province(2017CXGC1214).
文摘The aim of this study was to explore the associations of moderate-to-vigorous-intensity physical activity(MVPA)time and sedentary(SED)time with a history of cardiovascular disease(CVD)and multifactorial(i.e.,blood pressure(BP),body mass index(BMI),low-density lipoprotein cholesterol(LDL-C),and glycated hemoglobin A1c(HbA1c))control status among type 2 diabetes mellitus(T2DM)patients in China.A cross-sectional analysis of 9152 people with type 2 diabetes from the Multifactorial Intervention on Type 2 Diabetes(MIDiab)study was performed.Patients were grouped according to their self-reported MVPA time(low,<150 min·week−1;moderate,150 to<450 min·week−1;high,≥450 min·week−1)and SED time(low,<4 h·d–1;moderate,4 to<8 h·d–1;high,≥8 h·d–1).Participants who self-reported a history of CVD were identified as having a CVD risk.Odds ratios(ORs)and 95%confidence intervals(CIs)of CVD risk and multifactorial control status associated with MVPA time and SED time were estimated using mixed-effect logistic regression models,adjusting for China’s geographical region characteristics.The participants had a mean±standard deviation(SD)age of(60.87±8.44)years,44.5%were women,and 25.1%had CVD.After adjustment for potential confounding factors,an inverse association between high MVPA time and CVD risk that was independent of SED time was found,whereas this association was not observed in the moderate-MVPA group.A higher MVPA time was more likely to have a positive effect on the control of BMI.Compared with the reference group(i.e.,those with MVPA time≥450 min·week−1 and SED time<4 h·d–1),CVD risk was higher in the low-MVPA group:The OR associated with an SED time<4 h·d–1 was 1.270(95%CI,1.040–1.553)and that associated with an SED time≥8 h·d–1 was 1.499(95%CI,1.149–1.955).We found that a high MVPA time(i.e.,≥450 min·week−1)was associated with lower odds of CVD risk regardless of SED time among patients with T2DM.
基金the Clinical Medical Research Center Project of Hainan Province,China,No.LCYX202207Key R&D Plan Project of Hainan Province,China,No.ZDYF2020118.
文摘BACKGROUND Hyperthyroidism often leads to tachycardia,but there are also sporadic reports of hyperthyroidism with severe bradycardia,such as sick sinus syndrome(SSS)and atrioventricular block.These disorders are a challenge for clinicians.CASE SUMMARY We describe three cases of hyperthyroidism with SSS and found 31 similar cases in a PubMed literature search.Through the analysis of these 34 cases,we found 21 cases of atrioventricular block and 13 cases of SSS,with 67.6%of the patients experiencing bradycardia symptoms.After drug treatment,temporary pacemaker implantation,or anti-hyperthyroidism treatment,the bradycardia of 27 patients(79.4%)was relieved,and the median recovery time was 5.5(2-8)d.Only 7 cases(20.6%)needed permanent pacemaker implantation.CONCLUSION Patients with hyperthyroidism should be aware of the risk of severe bradycardia.In most cases,drug treatment or temporary pacemaker placement is recommended for initial treatment.If the bradycardia does not improve after 1 wk,a permanent pacemaker should be implanted.
基金Wuxi Municipal Health Commission Maternal and Child Health Research Project,No.FYKY202206.
文摘BACKGROUND Obesity is associated with an increased risk of multiple extradigestive complic-ations.Thus,understanding the global epidemiology of obesity and its relation-ship with extradigestive complications,such as cardiovascular disease,type 2 diabetes mellitus,and non-alcoholic fatty liver disease is important.However,nutritional intervention can positively manage issues associated with obesity.Hence,the identification of the current high prevalence of extradigestive complica-tions among patients with obesity and the potential role of nutritional inter-ventions is also essential.AIM To determine the relationship between obesity and extradigestive complications and emphasize the importance of nutritional interventions in the management of patients with obesity.METHODS Overall,110 patients with obesity admitted to our hospital from February 2020 to November 2022 and 100 healthy individuals were included in the present study.Information of the study population,including demographic characteristics,such as age,sex,body mass index,indicators of extradigestive complications,dietary intake,and biomarkers was collected.The study design,participant selection,interventions,and development of the nutritional intervention program were described.The collected data were analyzed to assess the effect of nutritional inter-ventions on extradigestive complications.RESULTS As a part of nutritional intervention,the dietary structure was modified to decrease the saturated fatty acid and cholesterol intake and increase the dietary fiber and polyunsaturated fatty acid intake to improve the blood lipid levels and cardiovascular health.Mechanistic studies showed that these nutritional inter-ventions positively affected mechanisms that regulate lipid metabolism,improved inflammatory markers in the blood,and improved vascular functions.CONCLUSION The study discusses the consistency of the present results with previous findings to assess the clinical significance of the present findings.The study provides direction for future research on improving nutritional intervention strategies.
基金National Natural Science Foundation of China (No.82060503)。
文摘Objective:To investigate the variation,expression and clinical significance of E2F3 gene in melanoma.Methods:Firstly,cBioportal database,Oncomine database and GEO database were used to analyze the variation and expression level of E2F3 gene in melanoma.OSskcm database and TISIDB database were used to analyze the relationship between E2F3 and melanoma prognosis and tumor immune infiltrating cells.Then,the LinkedOmics database was used to identify the differential genes related to E2F3 expression in melanoma and analyze their biological functions.Finally,small molecule compounds for the treatment of melanoma were screened through the CMap database.Results:The mutation rate of E2F3 gene in melanoma is about 4%,and there are 21 mutation sites.Compared with normal skin tissues,the expression of E2F3 gene in melanoma was significantly increased(P<0.01).The mutation and increased expression of E2F3 gene were associated with the shortened overall survival(OS)of melanoma patients(P<0.05).The CNA level of E2F3 was negatively correlated with the expression levels of lymphocytes such as pDC,Neutrophil,Act DC and Th17,and negatively correlated with the expression levels of chemokines such as CXCL5,CCL13 and CCR1.The methylation level of E2F3 was positively correlated with the expression levels of Th1,Neutrophil,Act DC and other lymphocytes,and positively correlated with the expression levels of CXCL16,CXCL12,CCR1 and other chemokines.The expression level of E2F3 was negatively correlated with the expression levels of lymphocytes such as Th17,Tcm CD4 and Th1,and negatively correlated with the expression levels of chemokines such as CXCL 16,CCL 22 and CCL 2.The expression of 96 genes such as UHRF1BP1 in melanoma was significantly correlated with the expression of E2F3(|cor|0.5,P<0.05).The above genes were mainly related to RNA transport,eukaryotic ribosome biogenesis,cell cycle and other pathways.Among them,WDR12,WDR43,RBM28,UTP18,DKC1,PAK1IP1,DDX31,TEX10,TRUB1 and TRMT61B were the top 10 hub genes.YC-1,simvastatin,cytochalasin-d,Deforolimus and cytochalasin-b may be five small molecule compounds for the treatment of melanoma.Conclusion:The mutation and increased expression level of E2F3 gene are related to the poor prognosis of melanoma and participate in the occurrence and development of melanoma by affecting the expression of different tumor immune infiltrating cell subtypes,which may be a potential diagnostic marker and therapeutic target for melanoma.
文摘In recent years, the incidence of neurodegenerative diseases, mainly Alzheimer’s disease, Parkinson’s disease, vascular dementia, and cerebral ischemia, has been rising gradually, which has a serious impact on the physiological state and quality of life of human beings in old age, and the current clinical drugs are unsatisfactory in terms of therapeutic efficacy and healing, which has made this kind of diseases become a social medical problem. Tea polyphenols are the main functional components of tea and have great potential in neuroprotection. In this paper, we review the research on tea polyphenols in neurodegenerative diseases, with the aim of providing a new entry point for the treatment of neurodegenerative diseases.
文摘BACKGROUND Gastrointestinal surgery is a complicated process used to treat many gastrointestinal diseases,and it is associated with a large trauma:Most patients often have different degrees of malnutrition and immune dysfunction before surgery and are prone to various infectious complications during postoperative recovery,thus affecting the efficacy of surgical treatment.Therefore,early postoperative nutritional support can provide essential nutritional supply,restore the intestinal barrier and reduce complication occurrence.However,different studies have shown different conclusions.AIM To assess whether early postoperative nutritional support can improve the nutritional status of patients based on literature search and meta-analysis.METHODS Articles comparing the effect of early nutritional support and delayed nutritional support were retrieved from PubMed,EMBASE,Springer Link,Ovid,China National Knowledge Infrastructure,China Biology Medicine databases.Notably,only randomized controlled trial articles were retrieved from the databases(from establishment date to October 2022).The risk of bias of the included articles was determined using Cochrane Risk of Bias V2.0.The outcome indicators,such as albumin,prealbumin,and total protein,after statistical intervention were combined.RESULTS Fourteen literatures with 2145 adult patients undergoing gastrointestinal surgery(1138 patients(53.1%)receiving early postoperative nutritional support and 1007 patients(46.9%)receiving traditional nutritional support or delayed nutritional support)were included in this study.Seven of the 14 studies assessed early enteral nutrition while the other seven studies assessed early oral feeding.Furthermore,six literatures had"some risk of bias,"and eight literatures had"low risk".The overall quality of the included studies was good.Meta-analysis showed that patients receiving early nutritional support had slightly higher serum albumin levels,than patients receiving delayed nutritional support[MD(mean difference)=3.51,95%CI:-0.05 to 7.07,Z=1.93,P=0.05].Also,patients receiving early nutritional support had shorter hospital stay(MD=-2.29,95%CI:-2.89 to-1.69),Z=-7.46,P<0.0001)shorter first defecation time(MD=-1.00,95%CI:-1.37 to-0.64),Z=-5.42,P<0.0001),and fewer complications(Odd ratio=0.61,95%CI:0.50 to 0.76,Z=-4.52,P<0.0001)than patients receiving delayed nutritional support.CONCLUSION Early enteral nutritional support can slightly shorten the defecation time and overall hospital stay,reduce complication incidence,and accelerate the rehabilitation process of patients undergoing gastrointestinal surgery.
基金Acknowledgments We thank Drs Fengyong Liu and Sheng Luan at UC Berkeley, USA, for their discussion and help with the writing of the manuscript. This work was supported by grants from the National Natural Science Foundation of China （no. 30225037, 30471991, 30570731）, National Basic Research Program of China （973 Program） （no. 2006CB503909, 2004CB518603）, the ＂111＂ Project, and the Natural Science Foundation of Jiangsu Province （no. BK2004082, BK2006714）.
文摘·AIM: To determine the effects of laser photocoagulation on serum levels of angiopoietin-1(Ang-1),angiopoietin-2(Ang-2), soluble angiopoietin receptor Tie-2(Tie-2), Ang-1/Ang-2 ratio and vascular endothelial growth factor(VEGF) in patients with type 2diabetes mellitus(T2DM) and proliferative diabetic retinopathy(PDR). We also explored the role of the Ang/Tie system in PDR.·METHODS:Totally 160patientswithT2 DM, including50 patients with non-diabetic retinopathy(NDR), 58 patients with non-proliferative diabetic retinopathy(NPDR), and52 patients with PDR were enrolled in this study. Serum Ang-1, Ang-2, Tie-2 receptor and VEGF levels were measured using enzyme-linked immunosorbent assays for all patients and were repeated in 26 patients who underwent laser photocoagulation two months after the procedure.·RESULTS:ThemedianlevelsofAng-2andVEGFinserum were significantly higher in the NPDR group(4.23 ng/mL and 303.2 pg/mL, respectively) compared to the NDR group(2.67 ng/mL and 159.8 pg/mL, respectively, P <0.01), with the highest level in the PDR group(6.26 ng/mL and531.2 pg/mL, respectively, P <0.01). The median level of Ang-1 was significantly higher in the NPDR group(10.77ng/mL) compared to the NDR group(9.31 ng/mL) and the PDR groups(9.54 ng/mL)(P <0.05), while no difference was observed between the PDR and NDR groups. Ang-1/Ang-2 ratio of PDR group was lowest in three groups(1.49 vs 2.69 and 2.90, both P <0.01). The median level of Tie-2was not significantly different among three groups(P >0.05).Ang-2 was positively correlated with VEGF and Tie-2 in the PDR and NPDR groups(both P <0.05). Among the 26 patients who underwent laser photocoagulation, serum Ang-2 and VEGF levels significantly decreased(both P <0.05), whereas serum Ang-1 level and Ang-1/Ang-2ratio were weakly increased(P >0.05). The median levels of Ang-2 and VEGF in serum were highest in PDR group,however, Ang-1/Ang-2 ratio of PDR group was lowest in three groups.·CONCLUSION: Laser photocoagulation can reduce serum Ang-2 and VEGF levels. The Ang/Tie system and VEGF play an important role in the development and progression of T2 DM patients with PDR.
文摘The relationship of metabolic syndrome(MS)and its components with incident chronic kidney disease(CKD)and rapid decline of estimated glomerular filtration rate(eGFR)was investigated.A total of 10 140 patients participating in the epidemiological study(Risk Evaluation of Cancers in Chinese Diabetic Individuals,REACTION)of risk factors of type 2 diabetes in China were followed up for 3 years,with MS being diagnosed by adult treatment panel IH(ATP IH)combined with waist circumference in Asian population and renal function being evaluated by eGFR<60 mL min^-1(1.73 m^2)^-1 and rapid decline of eGFR≤30%.The results showed that as compared with the non-MS group,the adjusted odds ratios(ORs)of CKD and rapid decline of eGFR were 1.64(OR:1.64;95%CI:1.20-2.25,P<0.05)and 1.23(OR:1.23;95%CI:1.05-1.43,P<0.05)respectively in MS group.With the increase in the number(0,1,2,3 and≥4)of MS components,the prevalence of CKD was 1.42%,1.44%,2.80%,3.42%,and 4.03%(P<0.001),respectively.The ORs of incident CKD were 1.67(OR:1.67;95%CI:1.22-2.27,P<0.05)for high TG,1.50(OR:1.50;95%CI:1.10-2.05,P<0.05)for low HDL-C,and 1.39(OR:1.39;95%CI:1.02-1.91,P<0.05)for hyperglycemia.The risk for developing incident CKD was higher in the group with the highest HOMA-IR than in the group with the lowest HOMA-IR(OR:1.83;95%CI:1.16-2.89,P<0.05).It is suggested that MS is an independent risk factor for incident CKD.The occurrence and development of CKD is closely related to insulin resistance.
文摘Objective:To study the correlation of lipid ratios and individual lipid indexes of patients with type 2 diabetes with glycosylated hemoglobin(HbA<sub>1c</sub>).Methods:Samples were collected from 128 type 2 diabetic patients（aged 19-90 years;male 72,female 56）.The sera were analyzed for HbA<sub>1c</sub>,total cholesterol（TC）,triglycerides（TG）,high-density lipoprotein cholesterol（HDL-C） and low-density lipoprotein cholesterol（LDL-C）.According to the HbA<sub>1e</sub> level,the patients were divided into three groups,group A(HbA<sub>?</sub>【7%,n=31),group B(7%【HbA<sub>1c</sub>【10%,n=48),and group C(HbA<sub>1c</sub>】10%,n=49).The correlation of HbA<sub>1c</sub>with lipid ratios & individual lipid indexes were analyzed.Results:With the increased level of HbA（1c）,LDL-C had a significantly increasing trend（P【0.05）;whereas TC went up with the increased HbA（1c）,without any significant differences between three groups.There was no significant correlation between HbA<sub>1c</sub> and TG or HDL-C. With the increased level of HbA<sub>1c</sub>,TC/HDL-C,LDL-C/HDL-C ratios were gradually increased, with significant differences among groups（P【0.05）.The lipid ratios,especially LDL-C/HDL-C ratio was more susceptible to impaired lipid metabolism in T2DM patients than individual lipid. Conclusions:LDL-C/HDL-C ratio is helpful in assessing and reducing the risk of cardiovascular disease caused by impaired lipid metabolism in type 2 diabetic patients.
基金supported by a grant from the NIH:DK32333supported by the National Natural Science Foundation of China (81070693 and 81200647)
文摘In the 1970s,with the advent of biochemical multichannel screening in the United States and other western countries,the clinical presentation of primary hyperparathyroidism(PHPT) changed from a symptomatic to an asymptomatic disorder.However,in Asian countries,like China,PHPT did not show this evolution,but rather continued to be a symptomatic disease with target organ involvement.In this paper,we revisit the clinical features of PHPT in New York and Shanghai,representative United States and Chinese cites,over the past decade.The questions we address are whether the disease evolved in China to a more asymptomatic one and,whether in the United States further changes are evident.The results indicate that while PHPT con-tinues to present primarily as an asymptomatic disease in the United States,a new phenotype characterized by normal serum calcium and high parathyroid hormone levels,normocalcemic PHPT,has emerged.Data from Shanghai demonstrates a trend for PHPT to present more commonly as an asymptomatic disorder in China.However,most patients with PHPT in China still manifest classical symptoms,i.e.nephrolithiasis and fractures.A comparison of the two cohorts shows that Chinese patients with PHPT are younger,with higher serum calcium and PTH levels,and lower 25-hydroxyvitamin D levels than patients in New York.Normocalcemic PHPT has not yet been recognized in Shanghai.In summary,although the phenotypes of PHPT in both cities are evolving towards less evident disease,sharp clinical and biochemical differences are still apparent in PHPT as expressed in China and the United States.
基金supported by grants from the Collaborative Innovation Program of Shanghai Municipal Health Commission (2020CXJQ01)the National Natural Science Foundation of China (81873565 and 82100605)+2 种基金Shanghai Jiao Tong University Transmed Awards Research (20190104)Star Program of Shanghai Jiao Tong University (YG2021QN54)Hospital Funded Clinical Research,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (17CSK04 and 15LC06)。
文摘Background: Nonalcoholic fatty liver disease(NAFLD) was recently proposed to be renamed metabolic dysfunction-associated fatty liver disease(MAFLD) with the diagnostic criteria revised. We investigated the similarities and differences in the prevalence and clinical characteristics of MAFLD and NAFLD in Chinese adults. Methods: A cross-sectional study of 9980 Chinese individuals aged 40 years or older was performed between 2011 and 2012 using randomized, stratifed cluster sampling in Shanghai, China. A detailed questionnaire and the results of abdominal ultrasonography, a standardized 2-h 75-g oral glucose tolerance test and blood biochemical examinations were collected. Results: A total of 9927 subjects were included in this study. The prevalence of MAFLD(40.3%) was significantly higher than that of NAFLD(36.9%)( P < 0.05). MAFLD was highly prevalent in type 2 diabetes mellitus(T2DM)(53.8%), impaired fasting glucose(35.7%) and impaired glucose tolerance(40.9%). High risk of advanced fbrosis based on fbrosis-4 was highly prevalent(14.7%) in lean MAFLD with T2DM. Among 9927 subjects, 3481(35.1%) fulflled the diagnostic criteria for MAFLD and NAFLD(MAFLD + NAFLD +), 521(5.2%) MAFLD + NAFLD-, and 181(1.8%) MAFLD-NAFLD +. The MAFLD + NAFLD-group had more signifcant metabolic disorders than those in the MAFLD + NAFLD + group(all P < 0.05). Among MAFLD-NAFLD + subjects, 82.9% had metabolic disorders. Conclusions: The new defnition of MAFLD may better reflect the pathogenesis related to metabolism. Future research should focus on studying the natural history, pathogenesis and treatment effectivity of the overlap and non-overlap of NAFLD and MAFLD subjects.
基金supported by National Natural Science Foundation of China (NSFC) (81372851)
文摘This study was designed to investigate the effect of neoadjuvant chemotherapy on the expression of hormone receptors and Ki67 in Chinese female breast cancer patients. The expression of estrogen receptor(ER), progesterone receptor(PR) and Ki67 among 525 neoadjuvant chemotherapy cases was studied by immunohistochemistry.Differences between specimens made through preoperative core needle biopsy and excised tissue biopsy were observed. The positive rates of ER, PR and Ki67 in core needle biopsy and excised tissue biopsy were 65.3% and 63.2%, 51.0% and 42.6%, 65.6% and 43.4%, respectively. The expression of ER, PR and Ki67 in core needle biopsy and excised tissue biopsy had no statistically significant difference. However, after neoadjuvant chemotherapy, the discordance rates of ER, PR and Ki67 were 15.2%(79/521), 26.9%(140/520) and 44.8%(225/502), respectively. The ER, PR and Ki67 status changed from positive to negative in 7.5%(39/521), 13.3%(69/520) and 21.1%(106/502) of the patients, whereas ER, PR and Ki67 status changed from negative to positive in 7.7%(40/521), 13.6%(71/520)and 23.7%(119/502) of the patients, respectively. These results showed that the status of some biomarkers changes after neoadjuvant chemotherapy and biomarker status needs to be reexamined to optimize adjuvant systemic therapy and better prognosis assessment.
基金supported by the National Natural Science Foundation of China(No.81100617)the Medical and Health Science and Technology Development Projects of Shandong Province(2011HD005)+4 种基金the National Science and Technology Support Plan(2009BAI80B04)the Natural Science Foundation of Shandong Province(ZR2012HM014)the International Science and Technology Projects of Shandong Province(2010GHZ20201,2012GGE27126)the Business Plan of Jinan Students Studying Abroad(20110407)the special scientific research fund of clinical medicine of Chinese Medical Association(12030420342)
文摘Objective To study the optimal waist circumference(WC) cut-off values for identifying metabolic risk factors in middle-aged and elderly subjects in Shandong Province of China. Methods A total of 2 873 men and 5 559 women were included in this cross-sectional study. Metabolic syndrome(MetS) was diagnosed according to the definition of Chinese Diabetes Society in 2004. The relation between WC and MetS was analyzed by multivariate logistic regression analysis. The optimal WC cut-off values were identified using the area under the ROC curve and the different diagnostic criteria for central obesity were compared. Results The WC was the risk factor for MetS independent of BMI, blood glucose, blood lipid, and blood pressure. The optimal WC cut-off value was 83.8 cm and 91.1 cm for identifying MetS in women and men, respectively. Compared with 80 cm and 85 cm for women and men, 85 cm and 90 cm had a higher Youden index for identifying all metabolic risk factors and MetS in women and men. Conclusion The appropriate WC cut-off value is 85 cm and 90 cm for identifying central obesity and MetS in women and men in Shandong Province of China.
基金Supported by Research Project of Science and Technology Commission of Shanghai (04DZ19507).
文摘Objective To compare the influence of different sulfonylureas on the myocardial protection effect of ischemic preconditioning (IPC) in isolated rat hearts, and ATP-sensitive potassium channel current (IKATP) of rat ventricular myocytes. Methods Isolated Langendorff perfused rat hearts were randomly assigned to five groups: (1) control group, (2) IPC group, (3) IPC+glibenclamide (GLB, 10 μmol/L) group, (4) IPC+glimepiride (GLM, 10 μmol/L) group, (5) IPC+gliclazide (GLC, 50 μmol/L) group. IPC was defined as 3 cycles of 5-minute zero-flow global ischemia followed by 5-minute reperfusion. The haemodynamic parameters and the infarct size of each isolated heart were recorded. And the sarcolemmal IKATP of dissociated ventricular myocytes reperfused with 10 μmol/L GLB, 1 μmol/L GLM, and 1 μmol/L GLC was recorded with single-pipette whole-cell voltage clamp under simulated ischemic condition. Results The infarct sizes of rat hearts in IPC (23.7%±1.3%), IPC+GLM (24.6%±1.0%), and IPC+GLC (33.1%±1.3%) groups were all significantly smaller than that in control group (43.3%±1.8%; P<0.01, n=6). The infarct size of rat hearts in IPC+GLB group (40.4%±1.4%) was significantly larger than that in IPC group (P<0.01, n=6). Under simulated ischemic condition, GLB (10 μmol/L) decreased IKATP from 20.65±7.80 to 9.09±0.10 pA/pF (P<0.01, n=6), GLM (1 μmol/L) did not significantly inhibit IKATP (n=6), and GLC (1 μmol/L) decreased IKATP from 16.73±0.97 to 11.18±3.56 pA/pF(P<0.05, n=6). Conclusions GLM has less effect on myocardial protection of IPC than GLB and GLC. Blockage of sarcolemmal ATP-sensitive potassium channels in myocardium might play an important role in diminishing IPC-induced protection of GLM, GLB, and GLC.
